Difference between revisions of "Non-malignant skin disease"

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Non-malignant skin disease (view source)

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'''Non-malignant skin disease''' is relatively common.  The pathology may or may not be specific.  Some diseases require clinical information to diagnose.
'''Non-malignant skin disease''' is relatively common.  The pathology may or may not be specific.  Some diseases require clinical information to diagnose.  


An introduction to dermatopathology is in the ''[[dermatopathology]]'' article.  [[Nevi]] (moles) and other melanocytic lesions are dealt with in the article ''[[melanocytic lesions]]''.  Inflammatory skin conditions are dealt with in ''[[inflammatory skin disorders]]''.
An introduction to dermatopathology is in the ''[[dermatopathology]]'' article.  [[Nevi]] (moles) and other melanocytic lesions are dealt with in the article ''[[melanocytic lesions]]''.  Inflammatory skin conditions are dealt with in ''[[inflammatory skin disorders]]''.
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*[[Exocytosis]] - blood cell infiltrate the epidermis.
*[[Exocytosis]] - blood cell infiltrate the epidermis.


Images:
====Images====
*[[WC]]:
<gallery>
**[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_intermed_mag.jpg Dermatomycosis - intermed. mag. (WC)].
Image:Dermatomycosis_-_intermed_mag.jpg | Dermatomycosis - intermed. mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_high_mag.jpg Dermatomycosis - high mag. (WC)].
Image:Dermatomycosis_-_high_mag.jpg | Dermatomycosis - high mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_gms_-_low_mag.jpg Dermatomycosis - GMS stain - low mag. (WC)].
Image:Dermatomycosis_-_gms_-_low_mag.jpg | Dermatomycosis - GMS stain - low mag. (WC)
**[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_gms_-_high_mag.jpg Dermatomycosis - GMS stain - high mag. (WC)].
Image:Dermatomycosis_-_gms_-_high_mag.jpg | Dermatomycosis - GMS stain - high mag. (WC)
*www:
</gallery>
**[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/tinea_pas.jpg Dermatophytosis (ucsf.edu)].<ref>URL: [http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html]. Accessed on: 25 February 2013.</ref>
www:
*[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/tinea_pas.jpg Dermatophytosis (ucsf.edu)].<ref>URL: [http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html]. Accessed on: 25 February 2013.</ref>


===Stains===
===Stains===
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Notes:
Notes:
*It differs from verruca vulgaris... (1) orthokeratosis, (2) flat surface and base.
*It differs from [[verruca vulgaris]]... (1) orthokeratosis, (2) flat surface and base.


Images:
====Images====
www:
*[http://www.fujita-hu.ac.jp/~tsutsumi/case/case180.htm Verruca plana - several images (fujita-hu.ac.jp)].
*[http://www.fujita-hu.ac.jp/~tsutsumi/case/case180.htm Verruca plana - several images (fujita-hu.ac.jp)].
*[http://bg.convdocs.org/pars_docs/refs/55/54881/54881_html_m70d4f7e5.jpg Verruca plana (convdocs.org)].<ref>URL: [http://bg.convdocs.org/docs/index-54881.html?page=10 http://bg.convdocs.org/docs/index-54881.html?page=10]. Accessed on: 9 October 2013.</ref>
*[http://www.dermatopathonline.com/verruca%20plana2.html Verruca plana - several good images (dermatopathonline.com)].
*[http://www.dermatopathonline.com/verruca%20plana2.html Verruca plana - several good images (dermatopathonline.com)].


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==Clear cell acanthoma==
==Clear cell acanthoma==
===General===
{{Main|Clear cell acanthoma}}
*Benign.
*Elderly.
*Classically on the leg.<ref name=pmid18583817>{{Cite journal  | last1 = Akin | first1 = FY. | last2 = Ertam | first2 = I. | last3 = Ceylan | first3 = C. | last4 = Kazandi | first4 = A. | last5 = Ozdemir | first5 = F. | title = Clear cell acanthoma: new observations on dermatoscopy. | journal = Indian J Dermatol Venereol Leprol | volume = 74 | issue = 3 | pages = 285-7 | month =  | year =  | doi =  | PMID = 18583817 | URL = http://www.ijdvl.com/text.asp?2008/74/3/285/41396 }}</ref>
*Rare.
*Clinically not distinct.
**Suspected clinically in only ~3% of cases.<ref name=pmid20931670>{{Cite journal  | last1 = Morrison | first1 = LK. | last2 = Duffey | first2 = M. | last3 = Janik | first3 = M. | last4 = Shamma | first4 = HN. | title = Clear cell acanthoma: a rare clinical diagnosis prior to biopsy. | journal = Int J Dermatol | volume = 49 | issue = 9 | pages = 1008-11 | month = Sep | year = 2010 | doi =  | PMID = 20931670 }}</ref>
 
===Microscopic===
Features:<ref>URL: [http://www.drmihm.com/cases/case.cfm?CaseID=45 http://www.drmihm.com/cases/case.cfm?CaseID=45]. Accessed on: 7 February 2012.</ref>
*Psoriasiform pattern - epidermal thickening ([[acanthosis]]).
*Keratinocytes:
**Pale or light pink cytoplasm (when compared to surrounding non-lesional keratinocytes).
**Separated from one another (spongiosis).
*+/-Stratum corneum [[neutrophil]]s.
 
DDx:
*[[Psoriasis vulgaris]].
 
Images:
*[http://www.drmihm.com/cases/casefigure.cfm?figID=906&CaseID=45 CCA (drmihm.com)].
*[http://www.dermatlas.com/derm/IndexDisplay.cfm?ImageID=-327718365 CCA - low mag. (dermatlas.com)].
*[http://www.dermatlas.com/derm/IndexDisplay.cfm?ImageID=546460717 CCA - high mag. (dermatlas.com)].


==Chondrodermatitis nodularis chronica helicis==
==Chondrodermatitis nodularis chronica helicis==
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===General===
===General===
*Benign.
*Benign.
*Looks like zit.
*Looks like a zit.


===Microscopic===
===Microscopic===
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==Lichenoid keratosis==
==Lichenoid keratosis==
*[[AKA]] ''lichen planus-like keratosis''.
*[[AKA]] ''lichen planus-like keratosis''.
*[[AKA]] ''lichenoid keratosis''.
{{Main|Lichenoid keratosis}}
 
===General===
*Caucasians - middle age or older.
*May be a variant of [[seborrheic keratosis]] (with marked inflammation).<ref name=Ref_Derm346>{{Ref Derm|346}}</ref>
 
Clinical DDx:<ref name=Ref_Derm346>{{Ref Derm|346}}</ref>
*[[Basal cell carcinoma]], [[squamous cell carcinoma of the skin]], melanocytic neoplasm.
 
===Microscopic===
Features:<ref name=Ref_Derm347>{{Ref Derm|347}}</ref>
*Hyperkeratosis.
*Parakeratosis.
*Band of inflammatory cells at DE junction (lichenoid inflammation).
*Dead keratinocytes (Civatte bodies).
*Dermal melanophages.
 
DDx:
*[[Lichen planus]] - need clinical correlation (mucosal lesions).
*[[Drug reaction]].
*[[Cutaneous T-cell lymphoma]].
*Regressed melanocytic lesion, esp. [[malignant melanoma]].
*Lichenoid [[actinic keratosis]] - has atypical hyperchromatic basal cells - esp. at edge of lesion, usu. in the context of [[solar elastosis]].
 
Images:
*[http://www.dermpathexpert.com/id57.html Lichenoid keratosis (dermpathexpert.com)].
 
===Sign out===
<pre>
SKIN LESION, MID-MIDDLE BACK, PUNCH BIOPSY:
- LICHENOID KERATOSIS.
</pre>
 
====Incompletely excised====
<pre>
SKIN LESION, LEFT CHEST, PUNCH BIOPSY:
- LICHENOID KERATOSIS VERSUS ACTINIC KERATOSIS.
- NEGATIVE FOR BASAL CELL CARCINOMA.
- SEE COMMENT.
 
COMMENT:
No eosinophils are apparent. No melanocytic lesion is identified; however, excision of the
whole lesion to exclude a partially regressed melanocytic lesion is suggested.
</pre>


==Granuloma annulare==
==Granuloma annulare==
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Note:
Note:
*Several variants exist.<ref name=pmid18032900>{{Cite journal  | last1 = Jacyk | first1 = WK. | last2 = Rütten | first2 = A. | last3 = Requena | first3 = L. | title = Fibrous papule of the face with granular cells. | journal = Dermatology | volume = 216 | issue = 1 | pages = 56-9 | month =  | year = 2008 | doi = 10.1159/000109359 | PMID = 18032900 }}</ref>
*Several variants exist.<ref name=pmid18032900>{{Cite journal  | last1 = Jacyk | first1 = WK. | last2 = Rütten | first2 = A. | last3 = Requena | first3 = L. | title = Fibrous papule of the face with granular cells. | journal = Dermatology | volume = 216 | issue = 1 | pages = 56-9 | month =  | year = 2008 | doi = 10.1159/000109359 | PMID = 18032900 }}</ref>
===Images===
*[http://www.dermaamin.com/site/histopathology-of-the-skin/58-f/1739-fibrous-papule-angiofibroma-.html Fibrous papule (dermaamin.com)].


===Sign out===
===Sign out===
Michael
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